Medical Terminology Daily (MTD) is a blog sponsored by Clinical Anatomy Associates, Inc. as a service to the medical community. We post anatomical, medical or surgical terms, their meaning and usage, as well as biographical notes on anatomists, surgeons, and researchers through the ages. Be warned that some of the images used depict human anatomical specimens.

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A Moment in History

Andreas Vesalius Bruxellensis (1514- 1564)

A Flemish anatomist and surgeon, Andreas Vesalius was born on December 31, 1514 in Brussels, Belgium. He is considered to be the father of the science of Anatomy. Up until his studies and publications human anatomy studies consisted only on the confirmation of the old doctrines of Galen of Pergamon (129AD - 200AD). Anatomy professors would read to the students from Galen's work and a demonstrator would point in a body to the area being described, if a body was used at all. The reasoning was that there was no need to dissect since all that was needed to know was already written in Galen's books. Vesalius, Fallopius, and others started the change by describing what they actually saw in a dissection as opposed to what was supposed to be there. 

Vesalius had a notorious career, both as an anatomist and as a surgeon. His revolutionary book "De Humani Corporis Fabrica: Libri Septem" was published in May 26, 1543. One of the most famous anatomical images is his plate 22 of the book, called sometimes "The Hamlet". You can see this image if you hover over Vesalius' only known portrait which accompanies this article. Sir William Osler said of this book "... it is the greatest book ever printed, from which modern medicine dates" 

After the original 1543 printing, the Fabrica was reprinted in 1555. It was re-reprinted and translated in many languages, although many of these printings were low-quality copies with no respect for copyright or authorship.

The story of the wood blocks with the carved images used for the original printing extends into the 20th century. In 1934 these original wood blocks were used to print 617 copies of the book "Iconaes Anatomica". This book is rare and no more can be printed because, sadly, during a 1943 WWII bombing raid over Munich all the wood blocks were burnt.

One interesting aspect of the book was the landscape panorama in some of his most famous woodcuts which was only "discovered" until 1903.

Vesalius was controversial in life and he still is in death. We know that he died on his way back from a pilgrimage to Jerusalem, but how he died, and exactly where he died is lost in controversy. We do know he was alive when he set foot on the port of Zakynthos in the island of the same name in Greece. He is said to have suddenly collapsed and die at the gates of the city, presumably as a consequence of scurvy. Records show that he was interred in the cemetery of the Church of Santa Maria delle Grazie, but the city and the church were destroyed by an earthquake and Vesalius' grave lost to history. Modern researchers are looking into finding the lost grave and have identified the location of the cemetery. This story has not ended yet.

For a detailed biography of Andreas Vesalius CLICK HERE.

Personal note: To commemorate Andrea Vesalius' 500th birthday in 2014, there were many scientific meetings throughout the world, one of them was the "Vesalius Continuum" anatomical meeting on the island of Zakynthos, Greece on September 4-8, 2014. This is the island where Vesalius died in 1564. I had the opportunity to attend and there are several articles in this website on the presence of Andreas Vesalius on Zakynthos island. During 2015 I also attended a symposium on "Vesalius and the Invention of the Modern Body" at the St. Louis University. At this symposium I had the honor of meeting of Drs. Garrison and Hast, authors of the "New Fabrica". Dr. Miranda


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Henry Koplik, MD


This article is part of the series "A Moment in History" where we honor those who have contributed to the growth of medical knowledge in the areas of anatomy, medicine, surgery, and medical research.To search all the articles in this series, click here.

Henry Koplik, MD (1858 -1927). American pediatrician and researcher, was born in 1858 in the city of New York.  He received his MD from the College of Physicians and Surgeons at the Colombia University in New York. He spent several years studying in Berlin, Vienna, and Prague. Upon his return to the US he worked at the lower Manhattan Good Samaritan dispensary, where he later built a large pediatric outpatient clinic which became a model for the care of infants and children. In fact, under Dr Koplik's direction, this clinic became the world's first "milk depot" providing fresh milk and infant food for underprivileged mothers in the area. Dr. Koplik was one of the founders of the American Pediatric Society, and was one of its presidents.

Mostly remembered by the pathognomonic and eponymic "Koplik's spots", Dr Koplik had many other achievements. Some of them include the prophylaxis of a milk depot, the strict discipline in diagnosis and care of the pediatric patient,  the discovery of the bacillus responsible for whooping cough, the prevention of cross-contamination at a pediatric ward, etc.

Dr. Koplik wrote a number of clinical and research papers on hygiene and public health, as well on a number of medical topics, plus a book on "Diseases of Infancy and Childhood". 

Sources:
1. "Koplik's Spots for the Record: an Illustrated Historical Note" Brem, J; Clin Ped 1972 11:3 161-163
2. "Pediatric Profiles: Henry Koplik (1858-1927)" Bass, MH J Ped 1957 119-125
3. "The History of the First Milk Depot or Gouttes de Lait With Consultations in America" JAMA 50: 1574, 1914.
4. "Some Pediatric Eponyms: Koplik's Spots," W. R. Bett Brit. J. Child.Dis. 28: 127, 1931 
Original imagecourtesy of National Institutes of Health.


Original imagecourtesy of National Institutes of Health.

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Aortic arch

The aortic arch is a segment of the aorta that arches from the midline towards posterior and to the left. It presents with three branches. From proximal to distal they are the brachiocephalic trunk, the left common carotid artery, and the left subclavian artery. There are several anatomical variations of the branches of the aortic arch.

There is no clear anatomical landmark to denote the ending of the ascending aorta and the beginning of the aortic arch, as there is no clear anatomical landmark to denote the ending of the aortic arch and the beginning of the descending aorta. Anatomists use as a reference a horizontal plane that passes through the angle of Louis. Since this plane also separates the inferior from the superior mediastinum, the aortic arch is found in the superior mediastium, while the ascending and descending aorta are found in the inferior mediastinum.

Aortic arch and branches

Heart - Anterior view  Click on the image for a larger version.

The aortic arch has anatomical relations with the bifurcation of the trachea, the pulmonary trunk and its bifurcation, and the left brachiocephalic vein. In its inferior surface, the aortic arch in the adult has the embryological remnant of the ductus arteriousus, called the ligamentum arteriosum.

The term "aortic arch" was coined and first used by Lorenz Heister (1683 1785) 

Image property of: CAA.Inc.Artist: Victoria G. Ratcliffe

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-angi-

This is a medical root term that originates from the Greek and means "vessel", as in a "container". The term is commonly misunderstood to mean "artery". The original meanings of the term in early Greek and Roman medicine where multiple. It was Lorenz Heister (1683-1758) who first used the term in its modern meaning. Applications of this root term include:

Angiology: Study of vessels
Angioma: Vessel tumor or mass, usually referred to a malformation of knotted vessels. The plural form is "angiomata"
Angioplasty: Reshaping of a vessel
Angiitis: Inflammation of a vessel. Note the double "i" in the word. This is the correct form of the term. "Angitis" is not correct!
Angiogenesis: Creation or generation of vessels
Neoangiogenesis: The prefix [neo-] means [new], therefore the term means "creation or generation of new vessels"
Cholangiogram: The prefix [chol-] means "bile", while the suffix [-ogram] means "examination of". A [cholangiogram] is the "examination of a bile vessel"
Cineangiogram: The prefix [cine-] means "movement", although we use it to mean "movie", while the suffix [-ogram] means "examination of". A [cineangiogram] is the "examination of a vessel in movement"

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-arthr-

This is a medical root term that originates from the Greek "arthron" which means "joint". The term is used in many medical words. Applications of this root term include:

• Arthrotomy: Opening of a joint
Arthritis: Inflammation (or infection) of a joint
Arthrology: Study of a joint
Arthrodesis: Fixation of a joint
Arthropathy: A disease affecting a joint
Arthroplasty: Reshaping of a joint
Arthroscopy: Visualizing inside a joint with a scope

As a side note: What is the plural form for arthritis? Hover your cursor over the word "arthritis" to see the answer

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Charles H. McBurney, MD


This article is part of the series "A Moment in History" where we honor those who have contributed to the growth of medical knowledge in the areas of anatomy, medicine, surgery, and medical research.To search all the articles in this series, click here.

Charles H. McBurney, MD (1845- 1913). British surgeon and anatomist, Dr. McBurney studied at Harvard University, and received his MD from the Colombia University in New York. At the forefront of the aseptic technique revolution, Dr. MacBurney, following Halsted's example, required the use of surgical gloves and strict aseptic technique in his operating room, considered the "first modern operating room in America"

His studies focused on appendicitis, and demonstrated a point of maximum tenderness at a point "exactly between an inch and a half and two inches from the anterior spinous process of the ileum on a straight line drawn between that process and the umbilicus". This point has become known as the eponymic "McBurney's point". There is a discrepancy between the original description of this point by McBurney and some medical publications. Continuing his research on the surgical approach to the inflamed vermiform appendix, in 1894 Dr. MacBurney presented an approach that used a small incision for appendectomy. This incision is know today as "McBurney's incision."

Sources:
1. "Charles Heber McBurney (1845 – 1913)" Yale,SH and Musana, KA Clin Med Res. 2005 August; 3(3): 187–189.
2. "Charles McBurney (1845–1913)—point, sign, and incision"  JAMA 1966;197:1098–1099
3. "The first modern operating room in America"  Clemons BJ AORN J. 2000 Jan;71(1):164-8, 170

Original imagecourtesy of National Institutes of Health.
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Cardiac apex

The word [apex] is Latin and means "the top". It refers to the highest point in a mountain or in a pyramid; the point furthest from the base. The plural form is [apices].  There are several anatomical apices in the human body.

The cardiac apex (also known by the Latin term apex cordis) is a misunderstood term. It refers to the "top" of the heart, but this is clear only when you place the heart in such a way that the apex is actually pointing "up" (see image). In this position the heart is like a pyramid and the base will be the surface opposite the apex. The anatomical location of the apex of the heart is posterior to the left 5th intercostal space in adults, just medial to the left midclavicular line.

Click on the image for a larger picture.

Human heart - Cardiac apex
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